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Treatment of unilateral vocal fold paralysis with ansa cervicalis to recurrent nerve anastomosis in a young adolescent: European case report

Published online by Cambridge University Press:  29 June 2018

C van den Boer ,
A L Wiersma ,
J P Marie  and
J T van Lith-Bijl
C van den Boer*
Affiliation:
Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
A L Wiersma
Affiliation:
Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands
J P Marie
Affiliation:
Otolaryngology – Head and Neck Surgery Department, Rouen University Hospital, France
J T van Lith-Bijl
Affiliation:
Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, the Netherlands Department of Otorhinolaryngology, Flevo Hospital, Almere, the Netherlands
*
Author for correspondence: Dr Cindy van den Boer, Department of Otorhinolaryngology, Academic Medical Center, Meibergdreef 9, Postbus 22660, 1100 DD Amsterdam, the Netherlands E-mail: c.vandenboer@amc.nl Fax: +31 20 691 3850
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Abstract

Background

Laryngeal re-innervation in paediatric unilateral vocal fold paralysis is a relatively new treatment option, of which there has been little reported experience in Europe.

Methods

In this European case report of a 13-year-old boy with dysphonia secondary to left-sided unilateral vocal fold paralysis after cardiac surgery, the patient underwent re-innervation using an ansa cervicalis to recurrent laryngeal nerve transfer, in combination with fat augmentation, after 12 years of nerve denervation. Perceptual analysis data, and acoustic and laryngoscopy recordings were acquired pre-operatively, and at one and two years post-operatively.

Results

The patient's perceptual voice quality was improved. He experienced subjective improvement and is very satisfied with the result. As expected, laryngoscopy at one and two years after surgery showed no physiological mobility of the vocal fold concerned, but improved closure during phonation was achieved. Electromyography showed evidence of re-innervation.

Conclusion

Laryngeal re-innervation could be considered as a treatment option for unilateral vocal fold paralysis in children and adolescents, even after a long-term delay.

Keywords

Laryngeal Nerve InjuriesVocal Cord ParalysisRecurrent Laryngeal NerveSurgeryAdolescentSpeech Therapy

Information

Type
Clinical Record
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 7 , July 2018 , pp. 661 - 664
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Dr C van den Boer takes responsibility for the integrity of the content of the paper

Presented at the Annual Meeting of the Dutch Society of Otorhinolaryngology and Head and Neck Surgery, 21 April 2017, Nieuwegein, the Netherlands, and at the Pan-European Voice Conference, 1 September 2017, Ghent, Belgium.

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